1. The Field of the Invention
The present invention relates to a filter for use in a body lumen, such as the vena cava. More particularly, the present invention relates to a lumen filter that has wall contacts.
2. Background
Vein thrombosis is a medical condition wherein a blood clot, or thrombus, has formed inside a vein. Such a clot often develops in the calves, legs, or lower abdomen, but can also affect other veins in the body. The clot may partially or completely block blood flow, and may break off and travel through the bloodstream. Commonly, the clot is caused by a pooling of blood in the vein, often when an individual is bed-ridden for an abnormally long duration of time, for example, when resting following surgery or suffering from a debilitating illness, such as a heart attack or traumatic injury. However, there are many other situations that cause the formation of a blood clot.
Vein thrombosis is a serious problem because of the danger that the clot may break off and travel through the bloodstream to the lungs, causing a pulmonary embolism. This is substantially a blockage of the blood supply to the lungs that causes severe hypoxia and cardiac failure, and frequently results in death. For many patients, anti-coagulant drug therapies may be sufficient to dissipate the clots. For example, patients may be treated with anticoagulants such as heparin and with thrombolytic agents such as streptokinase.
Unfortunately, some patients may not respond to such drug therapy or may not tolerate such therapy. Also, there may be other reasons why an anticoagulant is not desirable. For example, patients may have an acute sensitivity to heparin or may suffer from prolonged internal and/or external bleeding as a result of such drug therapies. Also, such drug therapies simply may be ineffective in preventing recurrent pulmonary emboli. In such circumstances, surgical procedures are required to prevent pulmonary emboli. Methods for prevention of primary or recurrent pulmonary emboli when anticoagulation therapies are ineffective are well-defined in the prior art. The current standard of therapy for prevention of pulmonary emboli in patients who are classified high-risk or are unable to be anticoagulated is percutaneous insertion and placement of an inferior vena cava filter device.
Additionally, a pulmonary embolism is an obstruction of the pulmonary artery or one of its branches by a blood clot or other foreign substance. A pulmonary embolism can be caused by a blood clot which migrated into the pulmonary artery or one of its branches. Mechanical interruption of the inferior vena cava presents an effective method of preventing of pulmonary embolisms.
Vena cava filters are devices which are implanted in the inferior vena cava, providing a mechanical barrier to undesirable particulates. The filters are used to filter peripheral venous blood clots and other particulates, which if remaining in the blood stream can migrate in the pulmonary artery or one of its branches and cause harm.
Conventional implantable blood filters employing a variety of geometries are known. Many are generally basket shaped, in order to provide adequate clot-trapping area while permitting sufficient blood flow. Also known are filters formed of various loops of wire, including some designed to partially deform the vessel wall in which they are implanted. A detailed discussion of the construction and use of such filters is contained in U.S. Pat. No. 5,893,869 issued to Barnhart, which is incorporated herein by reference. Additional information on such filters can also be found in an article entitled “Percutaneous Devices for Vena Cava Filtration” by Daniel E. Walsh and Michael Bettmann contained in Current Therapy in Vascular Surgery (3d ed. 1995) at pages 945-949; this article is also incorporated herein by reference.
Along with their many functional shapes, conventional filters may include other features. For example, peripheral arms may be provided to perform a centering function so that a filter is accurately axially aligned with the vessel in which it is implanted. In order to prevent migration under the pressure induced by normal circulation, many filters have anchoring features. Such anchoring features may include hook or ridges.
Many presently used vena cava filters are permanently implanted in the inferior vena cava and remain there for the duration of the patient's life or are removably implanted, but still which remain in position for long durations. As such, the filters can incur tissue ingrowth from the surrounding tissue, resulting in a decreased blood flow and in blood clots. While some permanent filters are designed to be percutaneously retrievable, they often become embedded as their anchoring features become endothelialized by the vessel wall and retrieval must be done surgically.